Automated respiratory cycles selection is highly specific and improves respiratory mechanics analysis.

in Pediatric Critical Care Medicine (2012), 13(4), 234-9

OBJECTIVE:: Selected optimal respiratory cycles should allow calculation of respiratory mechanic parameters focusing on patient-ventilator interaction. New computer software automatically selecting ... [more ▼]

OBJECTIVE:: Selected optimal respiratory cycles should allow calculation of respiratory mechanic parameters focusing on patient-ventilator interaction. New computer software automatically selecting optimal breaths and respiratory mechanic derived from those cycles are evaluated. DESIGN:: Retrospective study. SETTING:: University level III neonatal intensive care unit. SUBJECTS:: Ten mins synchronized intermittent mandatory ventilation and assist/control ventilation recordings from ten newborns. INTERVENTION:: The ventilator provided respiratory mechanic data (ventilator respiratory cycles) every 10 secs. Pressure, flow, and volume waves and pressure volume, pressure flow, and ventilator volume flow loops were reconstructed from continuous pressure/volume recordings. Visual assessment determined assisted leak-free optimal respiratory cycles (selected respiratory cycles). New software graded the quality of cycles (automated respiratory cycles). Respiratory mechanic values were derived from both sets of optimal cycles. We evaluated quality selection and compared mean values and their variability according to ventilatory mode and respiratory mechanic provenance. To assess discriminating power, all 45 "t" values obtained from interpatient comparisons were compared for each respiratory mechanic parameter. MEASUREMENTS AND MAIN RESULTS:: A total of 11,724 breaths are evaluated. automated respiratory cycle/selected respiratory cycle selections agreement is high: 88% of maximal kappa with linear weighting. Specificity and positive predictive values are 0.98 and 0.96, respectively. Averaged values are similar between automated respiratory cycle and ventilator respiratory cycle. C20/C alone is markedly decreased in automated respiratory cycle (1.27 +/- 0.37 vs. 1.81 +/- 0.67). Tidal volume apparent similarity disappears in assist/control: automated respiratory cycle tidal volume (4.8 +/- 1.0 mL/kg) is significantly lower than for ventilator respiratory cycle (5.6 +/- 1.8 mL/kg). Coefficients of variation decrease for all automated respiratory cycle parameters in all infants. "t" values from ventilator respiratory cycle data are two to three times higher than ventilator respiratory cycles. CONCLUSIONS:: Automated selection is highly specific. Automated respiratory cycle reflects most the interaction of both ventilator and patient. Improving discriminating power of ventilator monitoring will likely help in assessing disease status and following trends. Averaged parameters derived from automated respiratory cycles are more precise and could be displayed by ventilators to improve real-time fine tuning of ventilator settings. [less ▲]

Calcium and Phosphorus Homeostasis: Pathophysiology

in BUONOCORE, Giuseppe; BRACCI, Rodolfo; WEINDLING, Michael (Eds.) Neonatology. A practical approach to neonatal diseases. (2012)

Optimizing early nutritional support based on recent recommendations in VLBW infants and postnatal growth restriction

in Journal of Pediatric Gastroenterology and Nutrition (2011), 53(5), 536-542

Influence of HIV-1 and placental malaria co-infection on newborn biometry and Apgar scores in Kinshasa Democratic Republic of Congo

in Journal de Gynécologie, Obstétrique et Biologie de la Reproduction (2011), 40(5), 460-4

Objective The aim of this study was to assess the impact of HIV-1 and placental malaria co-infection on newborn biometry and Apgar scores. Methods 146 HIV-1 infected and 149 HIV-1 uninfected consent ... [more ▼]

Objective The aim of this study was to assess the impact of HIV-1 and placental malaria co-infection on newborn biometry and Apgar scores. Methods 146 HIV-1 infected and 149 HIV-1 uninfected consent mothers and their newborns were recruited. Placental biopsies examination confirmed the presence or absence of placental malaria. Birth weight (BW), placental weight, cranial circumference, brachial perimeter, height, Body Mass Index (BMI) and Apgar scores at 1’, 5’, 10’ were taken. The Chi2 test and t -Student test were used for data statistical analysis. Results The global placental malarial infection prevalence was 72% but was 91% in HIV-1 infected vs. 53.7% in HIV-1 uninfected mothers (p <0.0001). The mean BW of HIV-1 co-infected mother’s newborns was slightly inferior to that of HIV-1 uninfected mother’s babies (3,033±524g vs. 3,236±565g) but this difference was not statistically significant (p >0.05). No other significant biometric differences were noted (p >0.05). But, the co-infection influenced negatively Apgar scores at 5’ (p <0.05). Conclusion HIV-1 co-infected mothers were more frequently exposed to placental malaria infection. The co-infection reduced the Apgar scores taken at the fifth minute. [less ▲]

Automated respiratory cycles selection improves the variability of respiratory mechanics monitoring.

in Rimensberger, Peter (Ed.) 10th European Conference on Pediatric and Neonatal Ventilation program (2010, April)

Complications and recommendations concerning intravenous immunoglobulins in alloimmune hemolytic disease of the newborn

in Archives Françaises de Pédiatrie (2010), 17(3), 299-300

Nutrition du prématuré après la sortie: lait, vitamines, fer, diversification

in Archives Françaises de Pédiatrie (2010), 17

Newborns need another tune: « I will survive » sets neonatal resuscitation rhythm.

in Annals of Emergency Medicine (2009), 53(6), 837

Intérêt de la consommation de produit laitier et de la supplémentation en vitamine D au cours de la croissance.

in Journal du Pédiatre Belge (2009), 11(3), 24-27

On-line respiratory mechanic monitoring in newborns: reproducibility and effect of ventilatory mode

in Archives of Disease in Childhood (2008, November), 93(suppl II), 483

Objectives: Neonatal ventilator softwares provide information on respiratory mechanics (RM). Integration of those values with clinical variables could improve ventilation management. We investigated ... [more ▼]

Objectives: Neonatal ventilator softwares provide information on respiratory mechanics (RM). Integration of those values with clinical variables could improve ventilation management. We investigated accuracy and reproducibility of those variables in Assist Control (AC) and Synchronised Intermittent Mandatory Ventilation (SIMV) modes. [less ▲]